This narrative review revises the scientific evidence of recent years on healthy eating in children and adolescents, making sense of promising avenues of action, from a food system perspective. A conceptual framework is provided to better understand how eating habits of children and adolescents are shaped to identify key multisectoral approaches that should be implemented to promote healthier diets. The following influencing factors are discussed: individual factors (physiological and psychological factors, food preferences and food literacy competencies), factors within the personal and socio-cultural food environments, external food environments, and the supply chain. In each section, the main barriers to healthy eating are briefly discussed focussing on how to overcome them. Finally, a discussion with recommendations of actions is provided, anchored in scientific knowledge, and transferable to the general public, industry, and policymakers. We highlight that multidisciplinary approaches are not enough, a systems approach, with a truly holistic view, is needed. Apart from introducing systemic changes, a variety of interventions can be implemented at different levels to foster healthier diets in children through fostering healthier and more sustainable food environments, facilitating pleasurable sensory experiences, increasing their food literacy, and enhancing their agency by empowering them to make better food related decisions. Acknowledging children as unique individuals is required, through interpersonal interactions, as well as their role in their environments. Actions should aim to enable children and adolescents as active participants within sustainable food systems, to support healthier dietary behaviours that can be sustained throughout life, impacting health at a societal level.

Objective: As part of an update of feeding benchmarks targeting children aged 0–3 years, this study aimed to explore parental perceptions, information-seeking practices and needs concerning infant and young child feeding (IYCF) to design an efficient communication strategy.Design: Participants were recruited using the quota sampling to complete an online survey. Effects of parity, child age, prematurity, parental education and financial situation on parents’ responses were evaluated separately.Setting: France.Participants: A nationally representative sample of 1001 parents of children <4 years.Results: Parents whose child had any medical condition affecting feeding (children with medical condition (CMC), 17 %) were considered separately from healthy children’s parents. All the healthy children’s parents recognised the importance of IYCF for children’s health and growth; however, one-third considered the available advice contradictory and not guilt-free. The most used information sources were healthcare professionals (HCP, 81 %), internet (72 %) and parental networks (63 %). The most influential sources (mean influence ± sd) included HCP (7·7 ± 1·7/10), childcare professionals (7·3 ± 1·8/10) and parental networks (6·9 ± 1·8/10). Parents searched for practical tips for implementing IYCF starting when their child was 5 months old. Differences regarding the type of source used by parents with higher v. lower educations were small. Search strategies differed according to parity or child age but not to prematurity. The CMC parents reported slightly different practices and needs.Conclusions: Parents receive information from multiple sources, which can lead to confusion when deciding which advice to follow. A public health communication strategy adapted to the current parental needs should target these various sources.

Appropriate complementary feeding (CoF) is the key to preventing childhood obesity and promoting long-term health. Parents must be properly informed through the CoF process. Pediatricians have opportunities to interact with parents during the CoF transition and influence parental feeding decisions. They can convey public health nutrition messages to parents. With the release of new CoF recommendations in France in 2019, and from the perspective of their conversion into official public health communication material, the aim of this study was to explore parents’ and pediatricians’ perceptions and needs regarding information on CoF. Two online surveys were disseminated to gather information on CoF communication and guidance: one for parents (n = 1001, January 2020); one for pediatricians (n = 301, October 2019). The results showed that the importance of CoF for children’s healthy growth was well recognized by both parents and pediatricians. Parents acknowledged pediatricians as the most influential source of advice; and pediatricians were aware of their responsibility in counselling parents on CoF. However, pediatricians neglected the fact that parents gave high trust to their personal network when looking for advice. The Internet was a well-recognized source of information according to all. Diverging from what pediatricians considered useful, parents were interested in practical advice for implementing CoF. This study highlights common expectations and points of divergence between parents’ needs and pediatricians’ perceptions of those needs with regard to CoF information.

Formation of healthy eating habits in children aged 0-3 years : supporting the development of public health guidelines dissemination material and its evaluation with parents and healthcare professionals: Les mille premiers jours, de la grossesse à 2 ans, sont cruciaux, entre autres aspects, pour le développement d'habitudes alimentaires et de préférences alimentaires saines chez les enfants. Les pratiques alimentaires des parents influencent de manière significative les consommations et les choix alimentaires des nourrissons au cours de cette période. Par conséquent, les parents doivent être correctement informés et guidés tout au long du processus de diversification alimentaire. De nouvelles directives couvrant ce thème ont été publiées en France en juin 2019. Compte tenu des interactions fréquentes que les professionnels de santé, tels que les pédiatres, ont avec les parents lors de la diversification alimentaire, leur rôle peut être considéré comme fondamental pour la transmission d'informations correctes aux parents à ce sujet. Cette thèse vise à contribuer à l'élaboration d'une brochure papier pour diffuser ces recommandations de santé publique auprès du grand public. Elle consiste en quatre études visant d’une part à éclairer une nouvelle stratégie de communication en santé publique tenant compte des besoins des parents et des professionnels de santé en matière de communication sur l'alimentation des enfants ; et d’autre part à évaluer si le matériel développé (brochure papier) a un effet à court terme sur les connaissances parentales ; et enfin, s'il est évalué positivement par les professionnels de santé. Les résultats, rapportés dans quatre articles, ont mis en évidence que les professionnels de santé sont la source d'information la plus utilisée et la plus influente pour les parents. Certaines différences existaient concernant les besoins de communication des parents et les perceptions des pédiatres concernant ces besoins. En particulier, les parents demandent souvent des conseils à leur entourage et ils recherchent de conseils pratiques, divergeant en cela de l'opinion des pédiatres. La brochure papier a contribué à accroître les connaissances sur l'alimentation des enfants indépendamment des caractéristiques sociodémographiques parentales. Les professionnels ont évalué la brochure comme un bon outil pour soutenir leur discours lors des consultations. Ces résultats contribuent à la preuve pour les acteurs de santé publique lors de la mise à jour et de la diffusion des recommandations d'alimentation des enfants, dans le but ultime de construire une stratégie prenant en compte les besoins de tous les utilisateurs pour faciliter la circulation d'informations officielles et mises à jour.